title: Factors associated with menopausal symptom severity in middle-aged Brazilian women from the Brazilian Western Amazon.
abstract: OBJECTIVE
  To determine the frequency and severity of menopausal symptoms and associated factors in middle-aged Brazilian women.
  
  
  METHODS
  A cross-sectional study was carried out involving 1415 women aged 35-65 years attended at the Outpatient unit of the Clinicas Hospital of Rio Branco, Acre state, Brazil. The Menopause Rating Scale (MRS) was used to assess the severity of menopause symptoms. The Stata 10 statistical package was used for all data analysis whereas Pearson's x(2) nonparametric association test was used for bivariate analysis, adopting a level of statistical significance of 5%. On the multivariate analysis, independent variables positively associated with the dependent model were retained in the final model (p<0.005).
  
  
  RESULTS
  Overall, 54.1% of participants were premenopausal, 10.1% perimenopausal, and 35.8% postmenopausal. Irritability was the most frequent symptom (78.3%), followed by joint and muscular discomfort (74.8%), and anxiety (72.7%). Mean total MRS score was 15.6+8.8 (median 15). After adjusting for confounding factors, the logistic regression analysis found low educational level (OR:1.53; [95% CI:1.21-1.95]; p<0.001); self-perceived poor/very poor health (OR:4.48; [95% CI: 3.53-5.69]; p<0.001), and menopausal transition phase (OR:1.73; [95% CI:1.18-2.53]; p=0.005) to be statistically significantly associated with more severe menopausal symptoms.
  
  
  CONCLUSIONS
  Among Brazilian women, atypical symptoms of the menopause were the most frequently reported. Severe menopausal symptoms were more likely in women with low educational level, self-perceived poor health and at the menopausal transition phase.
authors.affiliation: Centre for Health Sciences and Sport, Federal University of Acre, Rio Branco, AC, Brazil. andrears@usp.br
authors.forename: Andréa Ramos
authors.initials: AR
authors.lastname: da Silva
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: d'Andretta Tanaka
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D007508:Irritable Mood; D016015:Logistic Models; D008593:Menopause; D008875:Middle Aged; D015999:Multivariate Analysis; D059352:Musculoskeletal Pain / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D010465:Perception; D047648:Perimenopause; D017698:Postmenopause; D017697:Premenopause; D015995:Prevalence; D012720:Severity of Illness Index
keywords: Menopausal transition; Menopause; Menopause Rating Scale; Symptoms